Endometriosis

About endometriosis

Endometriosis is a condition where tissue similar to the uterine lining grows in other places, such as around the ovaries or pelvis, and occasionally the bladder or bowel. Symptoms vary widely — from severe pain to very few noticeable signs — and, as the NHS notes, their severity does not necessarily reflect how extensive the condition is.

How it is diagnosed

Diagnosis can take time. Assessment may involve discussing your symptoms, an examination, imaging such as a transvaginal ultrasound or MRI, and sometimes a laparoscopy. Importantly, NICE guideline NG73 advises not to rule out endometriosis if the examination or imaging is normal, and to consider laparoscopy even when imaging looks normal in someone with suspected endometriosis. ESHRE supports a multimodal approach — combining symptoms and imaging — so that management can sometimes begin without laparoscopy being essential in every case.

Endometriosis and fertility

The link between endometriosis and fertility is complex. Some people with endometriosis conceive without difficulty; others may be referred to a fertility specialist or benefit from treatment such as IVF. Because experiences differ so much, care is tailored to the individual after specialist assessment.

Living with it

Alongside pain relief, hormone treatments, and sometimes surgery, good care also addresses fatigue and emotional wellbeing. ESHRE emphasises a holistic approach that recognises the impact endometriosis can have on daily life.

When to seek help sooner: very heavy bleeding (for example soaking through a pad or tampon every one to two hours), or severe, sudden pelvic pain, should be assessed promptly.